Fending Off Falls

Learning how to stay on your feet can help you avoid pain and disability.

By Claire Sykes

January 2010


It started out as an ordinary day of housecleaning for 91-year-old Paul Strouse, a Waverly, Ohio piano teacher. Then, without warning, he found himself flat on his back. “Instead of staying outside the shower stall to scrub it, I stood inside and suddenly my feet flew out from under me and I fell backwards,” says Strouse.

Strouse wasn’t seriously hurt, but others aren’t so lucky. Among Americans 65 years and older, a third fall each year. The results can be devastating: fractured hips and head injuries resulting in costly hospitalization and long-term nursing home care—and even death.

Losing Balance

Falls become more common with age. “Research shows that most people fall because the balancing mechanism of the inner ear begins to fail them, resulting in dizziness,” says Jim Buskirk, PT, SCS, of Peak and Balance Centers of America in Chicago. Neurological deficits caused by Parkinson’s disease, multiple sclerosis and strokes can also affect balance.


Age brings other hazards. Eye problems may blur vision. Standing up too quickly may cause lightheadedness. Arthritis can limit movement, as can nerve problems in the foot related to diabetes. Insomnia and some medications may leave you distracted, dizzy or sleepy.

Age also affects your ability to protect yourself during a fall. Weaker muscles mean you’re less likely to trust your hands and arms to break a tumble. And if you’re too sedentary, either out of habit or because of mobility problems, you may not have the strength to keep from falling in the first place.

Dementia can also lead to falling. “Some people can degenerate to a stage where they can’t think clearly enough to walk without falling,” says Buskirk. You can also be of sound mind and assume you can stand on a stool to reach that top kitchen shelf, when you really can’t.

Remaining Upright

Avoiding falls begins with using your head. “Be aware of your exposure to your environment and situations that could increase your chance of falling,” says Neil Alexander, director of the Mobility Research Center at the University of Michigan. Have a complete physical, which should include tests for balance, hearing and vision as well as checks of bone density and gait.

For stronger bones, eat calcium-rich foods such as kale, almonds, sesame seeds, sardines and raw apricots. “Emerging research suggests that vitamin D may reduce falls, especially for people with low blood levels of it, who have limited sun or dietary exposure,” says Alexander. Ginkgo biloba
has helped reduce dizziness in studies, while the amino acid beta-alanine may improve muscle endur­ance in older people.

Exercise is important in fall prevention. Weight-bearing activities such as walking strengthens bones. Yoga can also help. “Studies indicate that, for older adults, yoga has the potential to reduce fall-risk factors, specifically those related to balance and flexibility,” says Marieke Van Puym­broeck, assistant professor of therapeutic recreation at Indiana University in Bloomington, Indiana. Tai Chi, an ancient Chinese martial art that uses slow movements and a focus on the breath, can promote better balance.


And then there’s professional, individually guided balance training. If you decide to go this route, Alexander recommends staying with the program for at least three to four months. “This can involve learning specific movements, such as rapidly shifting your weight, taking short quick steps then one long one and turning while walking,” he says.

Try to fall-proof your home. Keep enough room between furniture to easily move around it, clear the floor of electrical cords and firmly secure rugs and carpets. In the bathroom, install grab bars, replace glass shower-stall doors with a curtain and slap down a non-slip rubber bathmat. Use nightlights and put light switches within reach of your bed.

Wherever you walk, wear well-fitting, low-heeled footwear with non-slip rubber soles. Strouse does, yet he still fell (again) on a restaurant floor slick from the day’s rains. “That day, I wasn’t feeling unsteady, but when I do, I carry a cane with me,” he says. “It gives me a certain security.”

Don’t let fear of falling make you inactive. Even if you’re decades away from your elderly years, take the necessary steps now to stay steady on your feet.

Exercises to Improve Balance and Flexibility

Begin with five repetitions of each of these exercises, building up to 10 repetitions as you get stronger:

  1. Raise up and down on your toes while holding onto a sturdy table or desk at waist height.
  2. While still holding onto the table, squat until you feel stress in your thighs, and then return to a standing position.
  3. Shift your weight from your right foot to your left and back again. One complete back-and-forth motion counts as one repetition.
  4. While sitting on a straight-backed chair with armrests, lift your legs until they are parallel with the floor and return.
  5. While seated, put your arms out to the side. Reach to the right with your right arm, release, then reach to the left and release. One reach to the right and then the left counts as one repetition.
  6. While lying down, gently raise one leg, bending the knee to your chest, release and then raise the other. One left-and-right raise counts as one repetition.
  7. While lying down, hold your arms against your sides and then lift them. Return them to the floor.

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